血浆D-二聚体及血小板/淋巴细胞比值对缺血性脑卒中老年患者预后的影响分析

Predictive effects of plasma D dimer and platelet/lymphocyte ratio on the prognosis of elderly patients with ischemic cerebral stroke

目的检测缺血性脑卒中老年患者血浆D-二聚体水平及血小板/淋巴细胞比值(PLR),并分析其与患者预后的关系。方法选取2017年7月至2018年12月确诊收治的缺血性脑卒中老年患者52例为研究组,选择同期老年健康体检者50例作为对照组,采用全自动生化仪检测血清D-二聚体水平,采用血细胞分析仪检测血小板计数(PLT)和淋巴细胞计数,采用酶比色法检测血清总胆固醇(TC)、三酰甘油(TG)、高密度脂蛋白胆固醇(HDL)、低密度脂蛋白胆固醇(LDL)水平。结果研究组患者血清TG、TC、LDL水平显著高于对照组(P<0.05),HDL水平显著低于对照组(P<0.05);研究组血清D-二聚体水平明显较对照组高(P<0.05);研究组血浆淋巴细胞计数显著低于对照组(P<0.05),PLR显著高于对照组(P<0.05);高血压、吸烟史、饮酒史、TG、TC、LDL、PLR、血清D-二聚体水平、NIHSS评分是预后不良的危险因素(P<0.05),HDL是保护性因素(P<0.05);入院时血浆PLR预测不良预后的曲线下面积为0.809,当入院PLR为106.475时,获得最大Youden指数0.486,对应敏感度为0.846,特异性为0.640。结论缺血性脑卒中老年患者血清D-二聚体水平高、PLR比例高是影响患者发生不良预后的危险因素。

Objective To investigate the predictive effects of plasma D dimer and platelet/lymphocyte ratio(PLR)on the prognosis of elderly patients with ischemic cerebral stroke.Methods Fifty-two elderly patients with ischemic cerebral stroke,who were treated in our hospital from July 2017 to December 2018,were enrolled as research group,at the same time,the other 50 healthy subjects who underwent physical examination in our hospital were enrolled as control group.Automatic biochemical analyzer was used to detect the serum levels of D dimer.And blood cell analyzer was used to detect the platelet count(PLT)and lymphocyte count.Moreover enzyme colorimetry was used to detect the serum levels of total cholesterol(TC),triglyceride(TG),high density lipoprotein(HDL)and low density lipoprotein(LDL).Results The serum levels of TG,TC,LDL,D dimer and PLR in research group were significantly higher than those in control group(P<0.05).However the levels of HDL and the plasma lymphocyte count in research group were significantly lower than those in control group(P<0.05).Moreover,hypertension,smoking history,drinking history,TG,TC,LDL,PLR,the serum levels of D dimer and NIHSS score were risk factors for poor prognosis of patients(P<0.05),and HDL was the protective factor(P<0.05).In addition,the area under the curve of plasma PLR predicting adverse prognosis was 0.809 on admission.When PLR was 106.475,the maximum Youden index was 0.486,the corresponding sensitivity was 0.846 and the specificity was 0.640.Conclusion The serum levels of D-dimer and PLR in elderly patients with ischemic cerebral stroke are significantly higher than those of healthy subjects.The higher serum levels of D dimer and PLR ratio are risk factors for poor prognosis in elderly patients with ischemic cerebral stroke.